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Persistent and extreme outliers in causes of death by state, 1999–2013

In the United States, state-specific mortality rates that are high relative to national rates can result from legitimate reasons or from variability in coding practices. This paper identifies instances of state-specific mortality rates that were at least twice the national rate in each of three cons...

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Autor principal: Boscoe, Francis P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PeerJ Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662577/
https://www.ncbi.nlm.nih.gov/pubmed/26623181
http://dx.doi.org/10.7717/peerj.1336
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author Boscoe, Francis P.
author_facet Boscoe, Francis P.
author_sort Boscoe, Francis P.
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description In the United States, state-specific mortality rates that are high relative to national rates can result from legitimate reasons or from variability in coding practices. This paper identifies instances of state-specific mortality rates that were at least twice the national rate in each of three consecutive five-year periods (termed persistent outliers), along with rates that were at least five times the national rate in at least one five-year period (termed extreme outliers). The resulting set of 71 outliers, 12 of which appear on both lists, illuminates mortality variations within the country, including some that are amenable to improvement either because they represent preventable causes of death or highlight weaknesses in coding techniques. Because the approach used here is based on relative rather than absolute mortality, it is not dominated by the most common causes of death such as heart disease and cancer.
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spelling pubmed-46625772015-11-30 Persistent and extreme outliers in causes of death by state, 1999–2013 Boscoe, Francis P. PeerJ Epidemiology In the United States, state-specific mortality rates that are high relative to national rates can result from legitimate reasons or from variability in coding practices. This paper identifies instances of state-specific mortality rates that were at least twice the national rate in each of three consecutive five-year periods (termed persistent outliers), along with rates that were at least five times the national rate in at least one five-year period (termed extreme outliers). The resulting set of 71 outliers, 12 of which appear on both lists, illuminates mortality variations within the country, including some that are amenable to improvement either because they represent preventable causes of death or highlight weaknesses in coding techniques. Because the approach used here is based on relative rather than absolute mortality, it is not dominated by the most common causes of death such as heart disease and cancer. PeerJ Inc. 2015-10-13 /pmc/articles/PMC4662577/ /pubmed/26623181 http://dx.doi.org/10.7717/peerj.1336 Text en © 2015 Boscoe http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.
spellingShingle Epidemiology
Boscoe, Francis P.
Persistent and extreme outliers in causes of death by state, 1999–2013
title Persistent and extreme outliers in causes of death by state, 1999–2013
title_full Persistent and extreme outliers in causes of death by state, 1999–2013
title_fullStr Persistent and extreme outliers in causes of death by state, 1999–2013
title_full_unstemmed Persistent and extreme outliers in causes of death by state, 1999–2013
title_short Persistent and extreme outliers in causes of death by state, 1999–2013
title_sort persistent and extreme outliers in causes of death by state, 1999–2013
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662577/
https://www.ncbi.nlm.nih.gov/pubmed/26623181
http://dx.doi.org/10.7717/peerj.1336
work_keys_str_mv AT boscoefrancisp persistentandextremeoutliersincausesofdeathbystate19992013